TÉCNICAS EXPERIMENTALES CON ADN

number of interesting issues emerging which focused on some of the key

factors which led to successes and challenges.

46 Right time, right place?

hostel on the basis that he was on the IB project, because as far as being in the hostel is concerned, he had massive OCD and couldn’t share things. We got him his own pots and pans. He suddenly decided that he wanted to start working out, but he couldn’t go to a gym, so we got him some weights, because he was making his own and was a bit dangerous. We got him, more importantly a hospital assessment and on medication for his mental health. He’s now gone back home to live with his mother. Which is fantastic as they weren’t really communicating prior to this. Now he’s quite stable with her. He’s now still taking his medication because he was at a stage where he realised he needed it. He’s now with the mental health team. He’s now come off the IB. He only cost £45.24 but totally changed his life.

(North Wales support worker)

Similarly, another client who was a rough sleeper and a heavy drug user was described as ‘unrecognisable’ near the end of the pilot:

Yeah. They have all surprised me. Today [name of client] came in with his photos for his provisional licence and he’s like, “thanks it’s been amazing. Everyone has been amazing.” Not just me everyone, all the agencies. He put his arms round me and said, “all right, I’m not going to see you now for six months [client going into rehab] I got your number and we will keep in touch.”

(Swansea support worker)

Inequity of IB as an approach?

There was an assessment, by one support worker, that the criteria for inclusion for acceptance onto the IB scheme could be unfair. Here an example was provided where she was committed to working with one client who was not acting on the support offered via the IB whilst other clients not affiliated to the scheme, but who could have benefited from involvement, did not have access.

rods, yeah, they are—it’s opening their eyes to there is life out there besides booze and drugs. The TV and that’s like a home comfort and it might be like, sod it, I will watch TV I won’t walk into town, it’s too cold. Whereas if they didn’t have the TV then they would walk into town, because they would want to come and see you, because they have got nothing to keep them in. I’m not saying they are causing trouble all the time but he’s having around 238 less interactions with the police in one year. That is a massive financial impact on the police budget.

(Swansea support worker)

Similarly, a client in another area, who was taken on near the end of IB pilot, was described as having a learning disability and high support needs. These needs had previously led to a history of engagement with the criminal justice sector and emergency healthcare – intimating at a potentially high cost to the public purse. In order to address what was seen as a ‘root cause’ of their issues, the support worker initiated a mental health services assessment, paid for via the IB, as a way of fast-tracking him to more appropriate service provision in an effort to reduce his demand for services.

IB as transformational

For some people the affiliation to the IB project was transformational. One support worker in North Wales describes how one client with severe mental health issues who was rough sleeping ended up being supported in his parental home. A step which was seen as being impossible without the focus of the pilot:

Once he started with us, we had a point of contact, but up until then they could never find him, because he had no mobile or it was never charged up. He didn’t do mobiles anyway. We got him into a hostel on the basis, because of his mental health problems. He’s a big gentle man, but there were issues with him being with other people. Other people were very worried, concerned about him. We got him into the

exclusion. At least two areas – Swansea and North Wales – were actively looking at ways in which this could become part of their portfolio of services. In addition, Cardiff was hopeful of trying to continue the approach in the future, dependent on funding:

Realistically, there is no way we could continue on this level of funding that was put in as a whole. However, what it shows is that we don’t need that level of funding… I think in terms of the general principle, I think trying to get a small budget looks as if it would be sufficient and then that should allow us to really try and just move in with the

funding. (Cardiff coordinator)

There were a number of areas which were seen as potential ways in which the IB approach could be further refined and improved. One issue revolved around the need to remove time limits for IB client engagement. Many workers noted that although the expectation was that people would be supported to achieve stable accommodation within the 18-24 months of the pilot, for many people this was not going to be possible. A large number of clients had particularly complex needs which meant this timescale proved arbitrary. It was deemed necessary to have a person-centred timescale for engagement dependent on the individual concerned:

I think the shift towards more case work has been useful. We are hoping that there is some money available just on a smaller basis and not the full £3,000 per client thing. Just having a bit of money available for the kind of routine stuff and the phones and the clothes and stuff that’s always been the biggest differences for people. I think people will say it’s the small things that make the most difference. If we can have a bit of money available for that that, would be great. Whether we get it or not is another thing. See how it goes.

(Cardiff support worker)

This has been aimed directly at the people who were sleeping on the streets, regularly. [Name of client] never slept on the streets. She’s dipped out of that way. I do feel, I had to speak to her last week about her rent. She was crying and she was sobbing. She said, I do get up and I go out and not like the rest of them here. That’s the only reason that she’s still here, because most people who are that high in arrears I would have to evict. We are hanging on and hanging on.

(Swansea support worker)

Similarly:

I find it difficult with some of the other clients when they say, well, why you doing that for him? Why have you bought him a £60 pair of boots and I haven’t got a £60 pair of boots. I find that very difficult because I couldn’t explain why they

weren’t on the list. (Swansea support worker)

This was an issue hinted at by a small number of IB recipients who considered that there may well be people ‘more worthy’ of support than themselves; this implied a level of discomfort as to being affiliated to a ‘special’ programme alongside friends who may well not have been.

Refining the IB approach

There was significant support for rolling out the IB approach in the future from workers and coordinators. There were some thoughts as to how best this could work. It was mentioned that choosing clients to go onto the pilot should be more selective. It was thought that people locked into significant levels of substance mis-use would benefit less from the approach for example. Similarly, there was a sense that some sort of pre-selection ‘readiness’ test be applied in order to ensure that the people who were targeted would be the ones most able to benefit from the approach.

All those workers consulted expressed a desire to see IB become another important tool in the repertoire of agencies to tackle rough sleeping and multiple

48 Right time, right place?

I think with the resources we’ve got it would continue as it is, really. At the maximum level we could work with. We are still part of the overall Outreach service in Cardiff which does mean that we have people on shifts doing the early morning breakfast run. We’ve got other commitments. I would say we probably have capacity.

(Cardiff coordinator)

Furthermore, having ready access to accommodation units, within which people could be placed, were seen as a major contributor to success in Cardiff by the coordinator and support worker.

There was also a difference in views on the scalability of the approach. Certain workers felt that this was an approach that could unlock the barriers faced by many entrenched rough sleepers and those who have been difficult to accommodate.

I think that this approach, even though it’s small scale at this point, could potentially be used in mainstream housing option services in order to provide housing solutions for all walks of life, to

be honest. (Bridgend coordinator)

Other workers felt that the IB would be best served as a small component in a broader toolkit. This conservative view was grounded in recognition of ensuring that the support worker dedicated to IB was able to devote as much time as was possible with clients in order to recognise the time investment required for success. For example, in Cardiff:

Conclusions

From a base of people who had had experience of entrenched rough sleeping, precarious housing and complex needs, the IB pilots were successful in ensuring more than 40 per cent of recipients were accommodated in stable accommodation within the two years of the project. A large number of other people were accommodated in some form of temporary accommodation. This represents the major success of the pilots.

A variety of non-accommodation related successes were also identified. Such successes included: a reduction in alcohol and substance mis-use, increasing self-esteem and self-confidence, an increase in trust and engagement with support services, more appropriate engagement with health and support services.

The pilots appear to demonstrate value for money. Less than half the allocated budget for the pilots was spent, which supported around 25 per cent more rough sleepers. Furthermore, workers cited potential significant savings to the public purse as a result of reduced levels of criminality and reactive health care in the majority of people affiliated to the pilots.

All areas saw value in the IB approach and there was a strong desire to replicate the approach within each area. Replication and expansion however was considered challenging without additional funding being made available.

The impact of the pilot on the lives of individuals can be conceptualised on a spectrum of outcomes. These include the following:

❚ Massive and dramatic change for a small cohort (e.g. from rough sleeping to living independently).

❚ Gradual and sustained change (e.g. more

engagement and sustained change).

❚ Speed bumps (e.g. stints in prison, relapse at

drinking but still engaged and making progress).

❚ Slight change (e.g. reduction in drinking and

communicating more with staff).

❚ ‘Supported’ status quo (e.g. attention on

safeguarding).

❚ No change (e.g. continuation of drinking, re-

offending).

There was a general lack of awareness from IB recipients as to presence of the programme, the budget and the size of the resource they have recourse to. As such, this individual budget approach excludes many of the key factors intrinsic within the personalisation concept. Although this did not appear to present many practical challenges to the delivery of the pilots, it is not known how far the ‘critical factors’ of choice, control and power were mobilised within Wales.

Effective and comprehensive planning of the IB is fundamental to the success of the approach. In particular, a number of key elements in the planning and coordination of IB were seen as central in order for the approach to be effective. These are:

❚ The development of effective and meaningful partnership arrangements between organisations.

❚ Excellent communication between organisations and workers.

❚ Appropriate and flexible workload allocations for

workers who will be required to undertake the IB work.

❚ Minimal bureaucratic procedures which will allow for immediate access to IB funds and/or quick reimbursement of expenditure.

Expenditure on the pilots was diverse. This

expenditure was used for a range of purposes. The purchase of items can help to develop and maintain trust between client and worker, they can help individuals release structural barriers (e.g. housing debt, bonds etc.), they can help people gain access to practical things (e.g. cycle, phone, clothes etc.) and they can help support psychological release (e.g. family reunification, horse riding, fishing etc.). These